Dying for the job: police work exposure and health. Violanti JM, ed. Springfield, IL: Charles C. Thomas Publisher, Ltd., 2014 Feb; :155-172
PTSD is frequently diagnosed following a single traumatic event; however epidemiologic research indicates that an individual's risk of PTSD increases with the number of traumatic experiences (Berger et al., 2012). In individuals with PTSD, repeated or chronic activation of the stress response systems (e.g. the SNS and HPA axis), may eventually result in their inefficient operation (Kim et al., 2011; O'Connor et al., 2000). This inefficient operation may result in the release of too much or too little of the physiologically active substances such as catecholamines and cortisol that play a role in dealing with threat (Kim et al., 2011; O'Connor et al., 2000). Abnormal levels of these substances are thought to be associated with the development of inflammatory, endocrine, cardiovascular, and psychiatric disorders in individuals with PTSD (Coughlin, 2011; Gupta, 2013; Lukaschek et al., 2013; Sareen et al., 2007). Because police officers are frequently exposed to traumatic incidents over their working lives, they are at an increased risk of PTSD. This in turn increases their risk of a number of other coexisting biological and psychological disorders such as CVD, diabetes, and depression (Gupta, 2013; Lukaschek et al., 2013; Marmar et al., 2006; Stearns, n.d.; Violanti, Andrew, et al., 2006; Violanti, Fekedulegn, et al., 2006). Because of the profound impact PTSD has on police officers, we should strive to prevent, diagnose and treat this disorder in this population.